Provider Demographics
NPI:1972047082
Name:STOCKTON, JENIFER (APRN)
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:
Last Name:STOCKTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JENIFER
Other - Middle Name:DAWN
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:3366 NW EXPRESSWAY
Mailing Address - Street 2:BUILDING D SUITE 660
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4462
Mailing Address - Country:US
Mailing Address - Phone:405-947-3345
Mailing Address - Fax:
Practice Address - Street 1:3366 NW EXPRESSWAY
Practice Address - Street 2:BUILDING D SUITE 660
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4462
Practice Address - Country:US
Practice Address - Phone:405-947-3345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-08
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK94562363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily